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Progression of myopic maculopathy in a Caucasian cohort of highly myopic patients with long follow-up: a multistate analysis

  • Retinal Disorders
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Abstract

Purpose

This study aims to determine the probability of progression of myopic maculopathy according to age.

Methods

This is a longitudinal observational study of single-center retrospective cohort of Caucasian patients formed by 212 consecutive adults with high myopia. Main outcome measures were age, visual acuity (VA), refractive error (RE), follow-up time, and the macular status assessed at least 5 years apart according to the Meta-Analysis of Pathologic Myopia Study Group. The progression rate was calculated based on per 1000 eyes/year. Multistate models were fitted to identify the predictive factors and to calculate the most probable age of progression onset using the Aalen–Johansen estimator.

Results

We studied 220 eyes of 122 Caucasian patients. Mean age was 48.18 ± 14.1, mean follow-up 12.73 ± 5.81 years. One-hundred and fifty-two (69.1%) eyes progressed of category, and 96 (44%) worsened a mean of 0.3 logMAR units during follow-up. The progression rate was 32.21/1000 eyes/year. The probability of progressing increased with age; it was higher in women if there was a family history of myopia, worse VA, higher RE, or wide macular staphyloma. The probability of progressing from category 1 was > 0.6 after 70 years of age; from category 2, it was 0.7 after 70 years; and 0.5 from category 3 after 75 years. If choroidal neovascularization (CNV) appeared, this probability exceeded 0.7 between ages 45 and 55 for all categories.

Conclusion

The progression rate is lower than in a Japanese series. The vision worsened with disease progression, and the probability of both happening increased after the age of 70–75. If CNV appears, the risk of progression is very high at the age of 45–55.

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All data and materials are available upon request.

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Authors and Affiliations

  1. Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Campus Miguel Delibes, P° de Belén n° 17, 47011, Valladolid, Spain

    Rosa M. Coco-Martin, Minal Belani-Raju, Daniel de la Fuente-Gomez, María R. Sanabria & Itziar Fernández

  2. Red Temática de Investigación Cooperativa en Salud de Oftalmologia (Oftared), Instituto de Salud Carlos III, Madrid, Spain

    Rosa M. Coco-Martin

  3. Hospital Universitario Río Hortega, Valladolid, Spain

    Minal Belani-Raju

  4. Palencia Hospital Complex, Palencia, Spain

    María R. Sanabria

  5. Department of Statistics, University of Valladolid, Valladolid, Spain

    Itziar Fernández

Authors
  1. Rosa M. Coco-Martin
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Correspondence to Rosa M. Coco-Martin.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Coco-Martin, R.M., Belani-Raju, M., de la Fuente-Gomez, D. et al. Progression of myopic maculopathy in a Caucasian cohort of highly myopic patients with long follow-up: a multistate analysis. Graefes Arch Clin Exp Ophthalmol 259, 81–92 (2021). https://doi.org/10.1007/s00417-020-04795-5

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  • DOI: https://doi.org/10.1007/s00417-020-04795-5

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